Structured Interdisciplinary Rounds and Hospital Outcomes in a Southeastern U.S. Health System: A Retrospective Cohort Study.

Abstract

Structured Interdisciplinary Rounds (SIDRs) aim to improve communication, care coordination, and discharge planning by bringing multidisciplinary teams together for structured bedside discussions. Although widely promoted, few multisite evaluations have assessed their association with key hospital performance metrics compared with traditional rounding models. To evaluate the association of SIDRs with hospital efficiency, safety, and patient experience across a multi‑hospital health system. Retrospective cohort study comparing SIDR and traditional care units across four hospitals. A total of 11,334 inpatient discharges between July 1, 2023, and October 31, 2024. Daily structured interdisciplinary rounds conducted by physicians, nurses, case managers, pharmacists, and rehabilitation staff. Length of stay (LOS), observed‑to‑expected LOS (O/E LOS), case mix index (CMI)‑adjusted LOS, 30‑day readmissions, safety outcomes (falls, pressure injuries, medication errors per 1000 patient‑days), patient experience (HCAHPS communication and care‑transition domains), and complaints per 1000 patient‑days. SIDR units had lower O/E LOS compared with traditional units (1.35 vs 1.50; Δ - 0.15, 95% CI - 0.22 to - 0.05; p = 0.004). Unadjusted LOS was higher in SIDR units, whereas CMI‑adjusted LOS favored SIDR among moderate‑ and high‑complexity patients. Thirty‑day readmissions and patient‑experience scores did not differ significantly. Safety event rates were low in both groups, with no significant differences, although medication‑error reporting was likely under‑captured due to voluntary reporting systems. Unit‑level sensitivity analyses demonstrated site‑level heterogeneity but were directionally consistent with patient‑level findings, with risk‑adjusted advantages for SIDR most pronounced at one hospital. SIDRs were associated with lower risk‑adjusted LOS without differences in readmissions, safety events, or patient‑experience scores. Benefits were greatest among higher‑complexity patients, suggesting that structured interdisciplinary communication may be particularly impactful for patients requiring intensive coordination. Further research should incorporate broader safety indicators, process‑of‑care measures, and patient‑reported experience tools to more fully characterize the effects of SIDRs across diverse inpatient environments.